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Pantoprazole (Somac)

Overview

Field Detail
Drug class Proton pump inhibitor (PPI)
Stock vial 40 mg powder for injection
Reconstituted conc. 4 mg/mL (add 10 mL NS)
Storage Room temp before reconstitution; Store 2–8°C after

Preparation

Reconstitution

Pantoprazole is reconstituted to 4 mg/mL for skin testing. Ensure the 10 mL of Normal Saline (NS) is added and the solution is clear before use.

Equipment needed

  • 1 × Pantoprazole 40 mg powder vial
  • Normal saline (NS) — for reconstitution and dilutions
  • 10 mL syringe
  • 1 mL syringes × 4 (for test doses/dilutions)
  • 25 G needles

Step 1 — Reconstitute the stock (4 mg/mL)

  1. Add 10 mL of NS to the 40 mg powder vial.
  2. Shake gently until completely dissolved. (This is 4 mg/mL).
  3. Draw up 0.5–1 mL into a 1 mL syringe.
  4. Label: "Pantoprazole SPT 4 mg/mL".

Step 2 — Prepare IDT dilutions

Prepare in this order, using a fresh syringe for each step.

  1. IDT 0.4 mg/mL (1:10):

    • Draw 0.1 mL of stock (4 mg/mL) into a 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.4 mg/mL — 1:10).
    • Label: "Pantoprazole IDT 0.4 mg/mL".

  2. IDT 0.04 mg/mL (1:100):

    • Draw 0.1 mL of the 0.4 mg/mL syringe into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.04 mg/mL — 1:100).
    • Label: "Pantoprazole IDT 0.04 mg/mL".

  3. IDT 0.004 mg/mL (1:1,000):

    • Draw 0.1 mL of the 0.04 mg/mL syringe into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.004 mg/mL — 1:1,000).
    • Label: "Pantoprazole IDT 0.004 mg/mL".

Skin prick test (SPT)

Reagent Concentration
Test solution Neat (4 mg/mL)
Positive control Histamine 10 mg/mL
Negative control Normal saline

Interpretation: Wheal ≥3 mm vs negative control = positive.

Intradermal test (IDT)

Dilution series

Step Dilution Concentration Preparation
1 1:1,000 0.004 mg/mL 0.1 mL of 0.04 mg/mL + 0.9 mL NS
2 1:100 0.04 mg/mL 0.1 mL of 0.4 mg/mL + 0.9 mL NS
3 1:10 0.4 mg/mL 0.1 mL neat + 0.9 mL NS

Higher Concentrations

Testing with concentrations >0.4 mg/mL may cause false-positive (irritant) results and is generally avoided unless clinically indicated.

Inject: 0.05 mL intradermal. Read at 15–20 minutes.